How is a Miscarriage Diagnosed and Treated?

Miscarriage is unfortunately a common occurrence, complicating approximately 25 percent of pregnancies. Another term for a miscarriage is a “spontaneous abortion.” Dealing with this can be very difficult, so it is important to understand your options and what to expect.

Warning signs for miscarriage include spotting or vaginal bleeding, cramping, or a gush of fluid. It’s confusing because these can also occur in normal, healthy pregnancies. Therefore, it’s important to talk with your doctor or midwife if you notice these symptoms to see if further evaluation is needed.

An early miscarriage can be diagnosed a few ways. A blood test can be done to check your pregnancy hormone level. If this level does not increase or decreases over a few days, that is a sign the pregnancy is not developing normally. Ultrasounds can also be done, but this may not be useful very early in pregnancy as the developing fetus might be too small to be seen. Lastly, a physical exam to see if your cervix is dilated and to examine any bleeding can be helpful too.

If a miscarriage is diagnosed there are a few management options. One is to not do anything and allow your body to complete the miscarriage on its own. This is only an option if you are early in pregnancy and you are medically stable (that is, the bleeding is not dangerously heavy).

Another option is to take medication to help your uterus contract and complete the miscarriage. While this is often successful in earlier miscarriages, sometimes surgery is needed if the medication doesn’t work or you start to bleed too much. Lastly, a dilation and curettage (or D&C) is a surgical option to treat a miscarriage. This can be chosen first or if waiting or taking medicine does not work. Since every case needs to be individualized, it is important to make an informed decision with your doctor about what option is right for you.

When going through a miscarriage, many women want to know why this happened. Often the cause is not known, but when we do have an answer it is usually because of a chromosomal abnormality in the pregnancy, a medical condition in the mother (such as poorly controlled diabetes), abnormal uterine anatomy, an infection, or an immune system disorder.

Grieving is different for everyone going through a miscarriage, and it is important to make sure you get the support you need during this difficult time. Please ask your doctor or midwife for support and local resources to help get you through this difficult time.

Reviewed by Dr. Jen Lincoln, November 2018

Sources:

• The American Congress of Obstetricians/Gynecologists
• Your Pregnancy and Birth
• 4th ed.

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